Hashimoto's encephalopathy: Report of three cases
Journal
Journal of the Formosan Medical Association
Journal Volume
113
Journal Issue
11
Pages
862-866
Date Issued
2014
Author(s)
Chang J.-S.
Abstract
Both severe thyrotoxicosis and hypothyroidism may affect brain function and cause a change in consciousness, as seen with a thyroid storm or myxedema coma. However, encephalopathy may also develop in patients with autoimmune thyroid diseases independent of actual thyroid function level, and this is known as Hashimoto's encephalopathy. Although most patients are found to have Hashimoto's thyroiditis, less frequently they have Graves' disease. Clinical manifestations include epilepsy, disturbance of consciousness, cognitive impairment, memory loss, myoclonus, hallucinations, stroke-like episodes, tremor, involuntary movements, language impairment, and gait impairment. Hashimoto's encephalopathy is a relatively rare disease. As a good response can be obtained with corticosteroid therapy, early diagnosis and treatment is very beneficial for patients. Here we report three patients with Hashimoto's encephalopathy with typical manifestations of hallucinations that were associated with hypothyroidism, hyperthyroidism, and euthyroid status, respectively. They all showed a dramatic response to methylprednisolone pulse therapy. ? 2012 .
SDGs
Other Subjects
albumin; antithyroid agent; beta adrenergic receptor blocking agent; corticosteroid; creatine kinase; immunoglobulin G; levothyroxine; lugol; methylprednisolone; microsome antibody; neuroleptic agent; prednisone; propylthiouracil; protein; risperidone; thyroglobulin antibody; thyroid peroxidase antibody; thyrotropin; autoantibody; methylprednisolone; adult; aged; amnesia; Article; auditory hallucination; autoimmune thyroiditis; body temperature disorder; case report; cholesterol blood level; concentration loss; consciousness disorder; crying; delirium; depression; drug dose reduction; drug megadose; drug withdrawal; echography; electroencephalography; endocrine ophthalmopathy; female; free thyroxine index; gait disorder; goiter; Graves disease; hand tremor; Hashimoto disease; Hashimoto encephalopathy; human; hyperthyroidism; hypothyroidism; limb weakness; low drug dose; male; middle aged; myoclonus; nuclear magnetic resonance imaging; paranoia; persecutory delusion; pitch; protein cerebrospinal fluid level; psychosis; response time; short term memory; sinus tachycardia; thyroid crisis; thyroid echography; thyroid gland examination; visual hallucination; Brain Diseases; complication; Graves disease; hallucination; hypothyroidism; pathophysiology; thyroid gland; thyrotoxicosis; Aged; Autoantibodies; Brain Diseases; Female; Graves Disease; Hallucinations; Hashimoto Disease; Humans; Hypothyroidism; Male; Methylprednisolone; Middle Aged; Thyroid Gland; Thyroiditis, Autoimmune; Thyrotoxicosis
Publisher
Elsevier
Type
journal article